Assessing Displacement Risk in Relation to Health Outcomes among Black Women Living with HIV Using Spatial Analysis and Zip Code Level Data

Gentrification results in higher tax revenues, but also the displacement of longstanding residents. Housing insecurity has been associated with medication nonadherence among people with HIV; however, the existing literature does not assess neighborhood level variables (e.g., indicators of gentrification) in tandem with individual level variables to adequately assess the risk of displacement and its association with health outcomes. This study examines estimated displacement risk in relation to mental health symptoms, HIV medication adherence, and HIV viral load among Black women living with HIV (BWLWH). Baseline data was collected (2019-2020) among 151 Black women enrolled in a cohort study in Miami, FL on mental health symptoms, medication adherence, HIV viral load, and sociodemographic variables (e.g., income). We combine changes in zip code level data (2014-2019) on Black individuals, White individuals, bachelor's degree, owner occupied house, median gross rent, and Airbnb fees (2015-2019) for apartment, condominium, and houses to assess estimated displacement risk (dichotomized [0, 1]). Spatial analyses and nonlinear regression models accounting for robust standard errors are used to assess estimated risk of displacement and its association with health outcomes. Results indicate that higher estimated risk of displacement is related to (a) higher depressive symptoms, (b) higher trauma exposure, (c) higher symptoms of post-traumatic stress disorder, and (d) lower medication adherence. Our novel findings reiterate the importance of future research examining indicators of gentrification that may impact the risk of displacement for BWLWH and ultimately their well-being and health outcomes.